Shan Jiang is an Associate Professor of Landscape Architecture at the School of Design and Community Development, West Virginia University. She is also serving leadership roles in healthcare and therapeutic design for professional organizations, including the Council of Educators in Landscape Architecture (CELA) and the American Society of Landscape Architects (ASLA). Dr. Jiang was an AIA AAH Tuttle Fellow, Landscape Architecture Foundation Case Study Investigation (LAF-CSI) Fellow, and the Academy of Architecture for Health Foundation (AAHF) Research Fellow. Her primary research interests include the people–nature relationship, landscape design and human health, the application of biophilic principles to create supportive healthcare environments, and evidence-based design.

• CONTENTSList of figuresList of tablesAcknowledgementsCHAPTER 1. INTRODUCTION1Scope and Key Concepts 1Organization 1References 1CHAPTER 2. THE HISTORY AND THEORY OF NATURE’S THERAPEUTIC EFFECTS 1The Traditional Belief that Nature Heals1Air, Water, and Places1Trees, Flowers, and Herbs1Salubrious Urban Landscape in the 19th Century 1Nature’s Healing Mechanism: Contemporary Studies and Schools of Thoughts1Therapeutic Landscapes through the Lens of Medical Geography 1Evolutionary Perspectives1Biophilia and Biophilic Design1Attention-Restoration Theory 1Stress Reduction and the Aesthetic-Affective Model 1Toward an Integrative Framework 1References 1CHAPTER 3. RECONNECT PEOPLE AND NATURE THROUGH WINDOWS IN HEALTHCARE ENVIRONMENTS 1Effects of Windows and No Windows1Windowed versus Windowless Environments1Window Attributes1Size and shape of windows1Distances to the window1Content and Quality of Window Views1Views of nature versus built environments1Complexity of window views1Windows and Natural Daylight1Visual and Thermal Comfort1Windows, Views, and Daylight in Healthcare Environments1Windows in Healthcare Environments1Window effects for patients1Window effects for staff 1Natural Daylight in Healthcare Environments1Natural daylight for patients1Natural daylight for staff1References 1CHAPTER 4. HOSPITAL GREENSPACES AND SOME USAGE ISSUES 1People–Nature Relationship in Hospitals in History1A General Negligence 1From Courtyard Hospitals to Pavilion Plans1Lessons Learned from Tuberculosis Sanatoriums1Tuberculosis Sanatorium Movement 1Paimio Sanatorium1The site1The windows1The indoor–outdoor transition1Greenspaces in Contemporary Hospitals 1The Revival of Hospital Greenspaces1Current Usage Issues of Hospital Greenspaces through Post Occupancy Evaluations1Post Occupancy Evaluation (POE)1Study Sites1Findings from the Site Evaluation and Audit 1Focus Group Results 1Visual and experiential quality1Wellness programs and supportive features1Landscape maintenance and operation1Garden Locations Matter1References 1CHAPTER 5. TRANSPARENCY AND TRANSPARENT SPACES IN HOSPITAL DESIGN: FROM THEORIES TO PRACTICES1Phenomenal Transparency and Spatial Continuity as an Urban Approach 1Transparency: From Rowe and Slutzky (1963) to Hoesli (1997)1Phenomenal Transparency and Spatial Continuity 1A Continuum of Indoor–Outdoor Spaces 1Phenomenal Transparency: An Urban Design Approach 1Lessons Learned from the Venice Hospital1A Preliminary Pattern Language of Transparent Spaces in Hospitals1Pattern 1: Hierarchy of Landscape Realms1Pattern 2: Courtyards that Breathe1Pattern 3: Courtyards that Breathe1Pattern 4: Positive Outdoor Spaces1Pattern 5: Micro-Landscapes Along Narrow Wings 1Pattern 6: Cascading Roof Terraces 1Pattern 7: Transparent Arteries 1Pattern 8: Landscaped Arrival Zones 1Pattern 9: Dematerialized Edges 1Pattern 10: Atrium Gardens and Lightwells 1Pattern 11: Sequestered Gardens 1Pattern 12: Therapeutic Viewing Places1References 1CHAPTER 6. THE EFFECTS OF WINDOWS AND TRANSPARENCY ON PEOPLE’S WAITING EXPERIENCE IN HOSPITAL ENVIRONMENTS 1Research Questions and Hypotheses1Research Design1Study 1: Image Selection1Study 2: The Survey-Embedded Quasi-Experiment1Data Analysis and Results1Stress-Inducing Effect of Watching A Movie Stressor1Comparison of Psychophysiology Readings1Comparison of Mood Scores1Visual Preference Analysis 1Comparison of means1Level of transparency and visual preference 1Seat arrangement and visual preference 1Correlations among Psychophysiology Readings, Mood States, and Visual Preference1Factor Analysis1Six factors1Between-group comparison of visual preference scores by factors1Contribution to Existing Knowledge1Implications for Hospital Waiting Area Design1Spatial Layout, Amenities, and Aesthetics1Positive Distractions1Privacy, Support, and Control1Seating and Furniture1Health Information and Resources 1References 1CHAPTER 7. THE EFFECTS OF WINDOWS AND TRANSPARENCY ON PEOPLE’S WAYFINDING BEHAVIORS AND NAVIGATIONAL EXPERIENCE IN HOSPITALS1Large Hospitals and the Wayfinding Issues1Research Questions and Hypotheses1Research Design1Experiment Setup1Measurements and Data Collection Procedures1Data Analysis and Results1Wayfinding Performance and Behaviors in IVE Hospitals 1Participants’ Mood States Scores 1Environmental Attractiveness and Atmosphere Metrics Scores1Level of Presence in IVE Hospitals 1Preliminary Findings from Interviews 1Additional Takeaways1Summary of Findings from the Current Study1Additional Implications for Healthcare Circulation Spaces Design1Spatial Configuration and Design Elements1Environmental Identity, Signs, and Landmarks1Wayfinding Systems and Technology1For Specialty Facilities and Vulnerable Patients1References 1CHAPTER 8. CASE STUDIES1Pattern 1: Hierarchy of Landscape Realms1Pattern 2: Courtyards that Breathe1Pattern 3: Courtyards that Breathe1Pattern 4: Positive Outdoor Spaces1Pattern 5: Micro-Landscapes Along Narrow Wings 1Pattern 6: Cascading Roof Terraces 1Pattern 7: Transparent Arteries 1Pattern 8: Landscaped Arrival Zones 1Pattern 9: Dematerialized Edges 1Pattern 10: Atrium Gardens and Lightwells 1Pattern 11: Sequestered Gardens 1Pattern 12: Therapeutic Viewing Places1References 1CHAPTER 9. TOWARD THE SHIFTED PARADIGMS FOR HOSPITAL ENVIRONMENT DESIGN 1Patient-Centered Care and User-Centered Design1Integrating Evidence-Based Research and Design1The Shifting Paradigms of Hospital Environment Design1Roles of Landscape Architects1Trends of Hospital Greenspaces in the Pandemic Context1Disappearing Waiting Rooms: Wait in a Garden! 1Expanded Public Spaces with Integrated Nature Experience1Gardens in Intensive Care Units1Toward the Concept of Community Wellness Centers1References 1INDEX

Shan Jiang is an Associate Professor of Landscape Architecture at the School of Design and Community Development, West Virginia University. She is also serving leadership roles in healthcare and therapeutic design for professional organizations, including the Council of Educators in Landscape Architecture (CELA) and the American Society of Landscape Architects (ASLA). Dr. Jiang was an AIA AAH Tuttle Fellow, Landscape Architecture Foundation Case Study Investigation (LAF-CSI) Fellow, and the Academy of Architecture for Health Foundation (AAHF) Research Fellow. Her primary research interests include the people–nature relationship, landscape design and human health, the application of biophilic principles to create supportive healthcare environments, and evidence-based design.

• CONTENTSList of figuresList of tablesAcknowledgementsCHAPTER 1. INTRODUCTION1Scope and Key Concepts 1Organization 1References 1CHAPTER 2. THE HISTORY AND THEORY OF NATURE’S THERAPEUTIC EFFECTS 1The Traditional Belief that Nature Heals1Air, Water, and Places1Trees, Flowers, and Herbs1Salubrious Urban Landscape in the 19th Century 1Nature’s Healing Mechanism: Contemporary Studies and Schools of Thoughts1Therapeutic Landscapes through the Lens of Medical Geography 1Evolutionary Perspectives1Biophilia and Biophilic Design1Attention-Restoration Theory 1Stress Reduction and the Aesthetic-Affective Model 1Toward an Integrative Framework 1References 1CHAPTER 3. RECONNECT PEOPLE AND NATURE THROUGH WINDOWS IN HEALTHCARE ENVIRONMENTS 1Effects of Windows and No Windows1Windowed versus Windowless Environments1Window Attributes1Size and shape of windows1Distances to the window1Content and Quality of Window Views1Views of nature versus built environments1Complexity of window views1Windows and Natural Daylight1Visual and Thermal Comfort1Windows, Views, and Daylight in Healthcare Environments1Windows in Healthcare Environments1Window effects for patients1Window effects for staff 1Natural Daylight in Healthcare Environments1Natural daylight for patients1Natural daylight for staff1References 1CHAPTER 4. HOSPITAL GREENSPACES AND SOME USAGE ISSUES 1People–Nature Relationship in Hospitals in History1A General Negligence 1From Courtyard Hospitals to Pavilion Plans1Lessons Learned from Tuberculosis Sanatoriums1Tuberculosis Sanatorium Movement 1Paimio Sanatorium1The site1The windows1The indoor–outdoor transition1Greenspaces in Contemporary Hospitals 1The Revival of Hospital Greenspaces1Current Usage Issues of Hospital Greenspaces through Post Occupancy Evaluations1Post Occupancy Evaluation (POE)1Study Sites1Findings from the Site Evaluation and Audit 1Focus Group Results 1Visual and experiential quality1Wellness programs and supportive features1Landscape maintenance and operation1Garden Locations Matter1References 1CHAPTER 5. TRANSPARENCY AND TRANSPARENT SPACES IN HOSPITAL DESIGN: FROM THEORIES TO PRACTICES1Phenomenal Transparency and Spatial Continuity as an Urban Approach 1Transparency: From Rowe and Slutzky (1963) to Hoesli (1997)1Phenomenal Transparency and Spatial Continuity 1A Continuum of Indoor–Outdoor Spaces 1Phenomenal Transparency: An Urban Design Approach 1Lessons Learned from the Venice Hospital1A Preliminary Pattern Language of Transparent Spaces in Hospitals1Pattern 1: Hierarchy of Landscape Realms1Pattern 2: Courtyards that Breathe1Pattern 3: Courtyards that Breathe1Pattern 4: Positive Outdoor Spaces1Pattern 5: Micro-Landscapes Along Narrow Wings 1Pattern 6: Cascading Roof Terraces 1Pattern 7: Transparent Arteries 1Pattern 8: Landscaped Arrival Zones 1Pattern 9: Dematerialized Edges 1Pattern 10: Atrium Gardens and Lightwells 1Pattern 11: Sequestered Gardens 1Pattern 12: Therapeutic Viewing Places1References 1CHAPTER 6. THE EFFECTS OF WINDOWS AND TRANSPARENCY ON PEOPLE’S WAITING EXPERIENCE IN HOSPITAL ENVIRONMENTS 1Research Questions and Hypotheses1Research Design1Study 1: Image Selection1Study 2: The Survey-Embedded Quasi-Experiment1Data Analysis and Results1Stress-Inducing Effect of Watching A Movie Stressor1Comparison of Psychophysiology Readings1Comparison of Mood Scores1Visual Preference Analysis 1Comparison of means1Level of transparency and visual preference 1Seat arrangement and visual preference 1Correlations among Psychophysiology Readings, Mood States, and Visual Preference1Factor Analysis1Six factors1Between-group comparison of visual preference scores by factors1Contribution to Existing Knowledge1Implications for Hospital Waiting Area Design1Spatial Layout, Amenities, and Aesthetics1Positive Distractions1Privacy, Support, and Control1Seating and Furniture1Health Information and Resources 1References 1CHAPTER 7. THE EFFECTS OF WINDOWS AND TRANSPARENCY ON PEOPLE’S WAYFINDING BEHAVIORS AND NAVIGATIONAL EXPERIENCE IN HOSPITALS1Large Hospitals and the Wayfinding Issues1Research Questions and Hypotheses1Research Design1Experiment Setup1Measurements and Data Collection Procedures1Data Analysis and Results1Wayfinding Performance and Behaviors in IVE Hospitals 1Participants’ Mood States Scores 1Environmental Attractiveness and Atmosphere Metrics Scores1Level of Presence in IVE Hospitals 1Preliminary Findings from Interviews 1Additional Takeaways1Summary of Findings from the Current Study1Additional Implications for Healthcare Circulation Spaces Design1Spatial Configuration and Design Elements1Environmental Identity, Signs, and Landmarks1Wayfinding Systems and Technology1For Specialty Facilities and Vulnerable Patients1References 1CHAPTER 8. CASE STUDIES1Pattern 1: Hierarchy of Landscape Realms1Pattern 2: Courtyards that Breathe1Pattern 3: Courtyards that Breathe1Pattern 4: Positive Outdoor Spaces1Pattern 5: Micro-Landscapes Along Narrow Wings 1Pattern 6: Cascading Roof Terraces 1Pattern 7: Transparent Arteries 1Pattern 8: Landscaped Arrival Zones 1Pattern 9: Dematerialized Edges 1Pattern 10: Atrium Gardens and Lightwells 1Pattern 11: Sequestered Gardens 1Pattern 12: Therapeutic Viewing Places1References 1CHAPTER 9. TOWARD THE SHIFTED PARADIGMS FOR HOSPITAL ENVIRONMENT DESIGN 1Patient-Centered Care and User-Centered Design1Integrating Evidence-Based Research and Design1The Shifting Paradigms of Hospital Environment Design1Roles of Landscape Architects1Trends of Hospital Greenspaces in the Pandemic Context1Disappearing Waiting Rooms: Wait in a Garden! 1Expanded Public Spaces with Integrated Nature Experience1Gardens in Intensive Care Units1Toward the Concept of Community Wellness Centers1References 1INDEX

Shan Jiang is an Associate Professor of Landscape Architecture at the School of Design and Community Development, West Virginia University. She is also serving leadership roles in healthcare and therapeutic design for professional organizations, including the Council of Educators in Landscape Architecture (CELA) and the American Society of Landscape Architects (ASLA). Dr. Jiang was an AIA AAH Tuttle Fellow, Landscape Architecture Foundation Case Study Investigation (LAF-CSI) Fellow, and the Academy of Architecture for Health Foundation (AAHF) Research Fellow. Her primary research interests include the people–nature relationship, landscape design and human health, the application of biophilic principles to create supportive healthcare environments, and evidence-based design.

• CONTENTSList of figuresList of tablesAcknowledgementsCHAPTER 1. INTRODUCTION1Scope and Key Concepts 1Organization 1References 1CHAPTER 2. THE HISTORY AND THEORY OF NATURE’S THERAPEUTIC EFFECTS 1The Traditional Belief that Nature Heals1Air, Water, and Places1Trees, Flowers, and Herbs1Salubrious Urban Landscape in the 19th Century 1Nature’s Healing Mechanism: Contemporary Studies and Schools of Thoughts1Therapeutic Landscapes through the Lens of Medical Geography 1Evolutionary Perspectives1Biophilia and Biophilic Design1Attention-Restoration Theory 1Stress Reduction and the Aesthetic-Affective Model 1Toward an Integrative Framework 1References 1CHAPTER 3. RECONNECT PEOPLE AND NATURE THROUGH WINDOWS IN HEALTHCARE ENVIRONMENTS 1Effects of Windows and No Windows1Windowed versus Windowless Environments1Window Attributes1Size and shape of windows1Distances to the window1Content and Quality of Window Views1Views of nature versus built environments1Complexity of window views1Windows and Natural Daylight1Visual and Thermal Comfort1Windows, Views, and Daylight in Healthcare Environments1Windows in Healthcare Environments1Window effects for patients1Window effects for staff 1Natural Daylight in Healthcare Environments1Natural daylight for patients1Natural daylight for staff1References 1CHAPTER 4. HOSPITAL GREENSPACES AND SOME USAGE ISSUES 1People–Nature Relationship in Hospitals in History1A General Negligence 1From Courtyard Hospitals to Pavilion Plans1Lessons Learned from Tuberculosis Sanatoriums1Tuberculosis Sanatorium Movement 1Paimio Sanatorium1The site1The windows1The indoor–outdoor transition1Greenspaces in Contemporary Hospitals 1The Revival of Hospital Greenspaces1Current Usage Issues of Hospital Greenspaces through Post Occupancy Evaluations1Post Occupancy Evaluation (POE)1Study Sites1Findings from the Site Evaluation and Audit 1Focus Group Results 1Visual and experiential quality1Wellness programs and supportive features1Landscape maintenance and operation1Garden Locations Matter1References 1CHAPTER 5. TRANSPARENCY AND TRANSPARENT SPACES IN HOSPITAL DESIGN: FROM THEORIES TO PRACTICES1Phenomenal Transparency and Spatial Continuity as an Urban Approach 1Transparency: From Rowe and Slutzky (1963) to Hoesli (1997)1Phenomenal Transparency and Spatial Continuity 1A Continuum of Indoor–Outdoor Spaces 1Phenomenal Transparency: An Urban Design Approach 1Lessons Learned from the Venice Hospital1A Preliminary Pattern Language of Transparent Spaces in Hospitals1Pattern 1: Hierarchy of Landscape Realms1Pattern 2: Courtyards that Breathe1Pattern 3: Courtyards that Breathe1Pattern 4: Positive Outdoor Spaces1Pattern 5: Micro-Landscapes Along Narrow Wings 1Pattern 6: Cascading Roof Terraces 1Pattern 7: Transparent Arteries 1Pattern 8: Landscaped Arrival Zones 1Pattern 9: Dematerialized Edges 1Pattern 10: Atrium Gardens and Lightwells 1Pattern 11: Sequestered Gardens 1Pattern 12: Therapeutic Viewing Places1References 1CHAPTER 6. THE EFFECTS OF WINDOWS AND TRANSPARENCY ON PEOPLE’S WAITING EXPERIENCE IN HOSPITAL ENVIRONMENTS 1Research Questions and Hypotheses1Research Design1Study 1: Image Selection1Study 2: The Survey-Embedded Quasi-Experiment1Data Analysis and Results1Stress-Inducing Effect of Watching A Movie Stressor1Comparison of Psychophysiology Readings1Comparison of Mood Scores1Visual Preference Analysis 1Comparison of means1Level of transparency and visual preference 1Seat arrangement and visual preference 1Correlations among Psychophysiology Readings, Mood States, and Visual Preference1Factor Analysis1Six factors1Between-group comparison of visual preference scores by factors1Contribution to Existing Knowledge1Implications for Hospital Waiting Area Design1Spatial Layout, Amenities, and Aesthetics1Positive Distractions1Privacy, Support, and Control1Seating and Furniture1Health Information and Resources 1References 1CHAPTER 7. THE EFFECTS OF WINDOWS AND TRANSPARENCY ON PEOPLE’S WAYFINDING BEHAVIORS AND NAVIGATIONAL EXPERIENCE IN HOSPITALS1Large Hospitals and the Wayfinding Issues1Research Questions and Hypotheses1Research Design1Experiment Setup1Measurements and Data Collection Procedures1Data Analysis and Results1Wayfinding Performance and Behaviors in IVE Hospitals 1Participants’ Mood States Scores 1Environmental Attractiveness and Atmosphere Metrics Scores1Level of Presence in IVE Hospitals 1Preliminary Findings from Interviews 1Additional Takeaways1Summary of Findings from the Current Study1Additional Implications for Healthcare Circulation Spaces Design1Spatial Configuration and Design Elements1Environmental Identity, Signs, and Landmarks1Wayfinding Systems and Technology1For Specialty Facilities and Vulnerable Patients1References 1CHAPTER 8. CASE STUDIES1Pattern 1: Hierarchy of Landscape Realms1Pattern 2: Courtyards that Breathe1Pattern 3: Courtyards that Breathe1Pattern 4: Positive Outdoor Spaces1Pattern 5: Micro-Landscapes Along Narrow Wings 1Pattern 6: Cascading Roof Terraces 1Pattern 7: Transparent Arteries 1Pattern 8: Landscaped Arrival Zones 1Pattern 9: Dematerialized Edges 1Pattern 10: Atrium Gardens and Lightwells 1Pattern 11: Sequestered Gardens 1Pattern 12: Therapeutic Viewing Places1References 1CHAPTER 9. TOWARD THE SHIFTED PARADIGMS FOR HOSPITAL ENVIRONMENT DESIGN 1Patient-Centered Care and User-Centered Design1Integrating Evidence-Based Research and Design1The Shifting Paradigms of Hospital Environment Design1Roles of Landscape Architects1Trends of Hospital Greenspaces in the Pandemic Context1Disappearing Waiting Rooms: Wait in a Garden! 1Expanded Public Spaces with Integrated Nature Experience1Gardens in Intensive Care Units1Toward the Concept of Community Wellness Centers1References 1INDEX